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No. 622,902. Patented Apr. ll, I899. M. J. STEIN. NEGOTIABLE INSTRUMENT BLANK.

(Application main. 3, 1898.)

(No Model.)

(SUBJEC To THE COVENANTS AND CONDITIONS ENDORSED HEREO m m qmm dEmzmw III I II I..I.IN

llVVE/VTOH %1/ By I I v1 1 ATTORNEYS.

WITNESSES:

NITED STATES PATENT OFFICE.

MYER J. STEIN, OF NEW YORK, N. Y.

NEGOTlABLE-INSTRUMENT BLANK.

SPEGIIfIGATION forming part of Letters Patent No. 622,902, dated April 11, 1899 Application filed November 3, 1898. Serial No. 695,373. (No specimens.)

T0 aZZ whom, it may concern.-

Be it known that I, MY ER J. STEIN, a citizen of the United States, residing in the city of New York, in the borough of Manhattan and State of New York, have invented certain new and useful Improvements in Negotiable-Instrument Blanks, of which the following is a specification.

This invention relates to an improved blank for negotiable instrumentssuch as bankchecks, promissory notes, drafts, bills of eX- change, and the likewhich serves also when properly indorsed as a general release; and the invention consists of a negotiable-instrument blank comprising a sheet printed on the face side with a negotiable-instrument form and upon the reverse side with a general release and with a number of seals, and, further, in a clause of reference on the face side 'to the matter on the reverse side of the sheet,

as will be fully described hereinafter and finally pointed out in the claim.

-In the accompanying drawings, Figure 1 represents a front elevation, and Fig. 2 a rear elevation, of my improved negotiable-instrument blank.

Referring to the drawings, A represents the face side of my improved negotiable-instrument blank, which is arranged in the usual manner, according to the form of instrument desired'i. 6., either a check, promissory note, bill of exchange, or other negotiableinstrument-and contains the necessary blank spaces for the number of the instrument, date, name of bank, banker, or banking institution, name of payee, amount in writing as well as in figures, and name of drawer. In addition thereto are arranged on the face side, preferably below the blank for the name of the payee, the words Subject to the cove nants and conditions endorsed hereon or their equivalent, which thus forms the conedge of the paper, together with a suitable form of general release. The general release is printed alongside of said seals and partly upon the indorsement-lines and is preferably printed in ink of a light color, so that the indorsements can be written across the same in the usual positions upon the dotted lines.

The form of general release is such as to release the maker of the instrument from all claims which the payee may have against him up to the time of acceptance of the instrument. It is obvious that the dotted lines opposite each seal may be omitted, if desired, and the general release printed in the position shown or shifted so as to be entirely opposite the seals or printed so as toextend entirely from one end to the other of the paper without departing from the scope of my invention.

The advantages of my improved blank are that it acts, aside from its usual function, as a check, promissory note, or other negotiable instrument, according to the form upon the face, and as a general release under seal against any claims or indebtedness of the maker to the payee to the date of delivery and acceptance of theinstrument in question. In other words, it forms a negotiable instrument which proves itself instead of requiring special proof thereof.

Having thus described my invention, I claim as new and desire to secure by Letters Patent- A negotiable-instrument blank, consisting of a sheet printed on the face side with a negotiable-instrument form and a clause referring to additional matter on the reverse side of the sheet, and a number of seals sidewise of the space for the indorsement on said reverse side, and a form of general release adjacent to said seals, substantially as set forth.

In testimony that I claim the foregoing as my invention I have signed my name in presence of two subscribing witnesses.

MYER J. STEIN.

Vitnesses:

PAUL GOEPEL, M. HENRY WURTZEL. 

